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Idiopathic Issues

Is there a Middle Ground between Gold-Standard Care and Euthanasia in Veterinary Medicine?

Dr. Cari Wise is a 1999 graduate of the University of Missouri, College of Veterinary Medicine. She completed a Masters degree in Education from Argosy University in 2015. Throughout her career, Dr. Wise has utilized her veterinary education in variety of settings including private and corporate small animal practice, shelter medicine, spay/neuter clinics, veterinary relief services, start-up practice ownership, and veterinary technician education.

As veterinarians and pet owners, we are fortunate to live in a time where the understanding of animal diseases and options for diagnosis and treatment are far more advanced than ever before. As a result, we also live in a time where the cost to provide the new gold-standard care is also higher.

Every generation of veterinarians has had to figure out how to deal with people who cannot, or will not, pay for the care that is available for their animals. It is frustrating, and often heart breaking for all involved, especially when financial constraints lead to a decision to euthanize. And I think it’s getting worse.

You don’t have to look far into the world of social media to find a DVM being touted as “uncompassionate” or “just in it for the money” on some message board created by animal lovers. Seriously? Seriously. But this post isn’t about all the reasons those people are, well, just wrong.

It is about what we can do as veterinarians, despite the financial restraints. There are things we can do to help animals, even when pennies are tight. So why have we become afraid to do it?

Again, let’s look at social media. I love technology, but with it comes an open forum to say whatever you want about whomever you want. Facts optional. And mean words hurt, a lot. They also destroy relationships and businesses. Vet practices are no different.

Every day most vets do the best they can to help their animal patients within the confines of the animal owners. There is not a one-size-fits-all solution when it comes to medicine. But we are obligated to offer the client the gold-standard of care, and to make them aware of all of their options. It is then up to the pet owner to decide how to proceed.

Vets understand that pet owners might really want to go the gold-standard route, but their finances can’t support it. That’s okay. But euthanasia doesn’t have to be the only other option. There may be a Plan B, C, or D that can still help the pet, but cost less. Yet DVMs are becoming afraid to offer these options. Here’s why.

All is well when a pet owner elects an alternate (cheaper) plan and the pet recovers. But, when it doesn’t recover, or it gets worse and dies, then the firestorm, social-media bashing of the “terrible vet” ensues. Who wants to deal with that? We don’t.

The reality is, even with gold-standard care options, some pets will not get better, and some will die. Despite our best efforts, some pet owners just will not accept this reality. In these cases, the veterinarian will never win.

There are many treatment options from years ago, the Middle Ground, that still work. And they are often cheaper. We have become afraid to use them. Not because they have become illegal, but because they are no longer recognized as gold-standard, and anything less than gold-standard in the eyes of an angry client may get us publicly shamed or sued.

The key here is relationship. It is the relationship between veterinarian and animal owner that can ultimately open the door for the safe use of an alternate treatment plan. The relationship is something we can control, and it starts well before the need for a critical conversation occurs.

Get to know your client. Understand where their pet fits into their life. Remember its name. Don’t screw up its gender in conversation. Don’t race through well-pet appointments in order to accommodate the unscheduled sick ones to follow. These things make a difference. In the eyes of a client, it is these things that develop their opinion about your competence and motives.

A client who sees a different vet every time they visit the practice, feels rushed during an appointment, is treated rudely by support staff, doesn’t receive test results in a timely manner, is not called back, and is left with unanswered questions will not trust you. These are the time bombs, the clients who are one-unfortunate-animal-event-away from slaughtering you in the public eye. Is it fair? No. Is it real? Sadly, yes.

The availability of the Middle Ground is ultimately determined by the veterinarian’s ability to connect with the pet owners. It’s not easy. It takes practice. It requires genuine interactions. And remember, the Middle Ground should only be approached after Gold-Standard options have been communicated. In the end, it is ultimately up to the animal owner to choose (and pay for) the medical treatment of their pet.

Veterinary Terminology Primer

Look it UP or break it DOWN?

A medical dictionary is an obvious must-have for any veterinary student. Your vocabulary will expand exponentially as you learn.

Unfortunately, memorizing definitions, though helpful, is not enough to prepare you to think critically as you move forward in your career.

This reference was created to help you understand the foundations of veterinary terminology so you can quickly break down new terms instead of spending time looking them up!

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